Analgin, 500 mg/ml 2 ml 10 pcs

An analgesic non-narcotic medicine.

ATX code [N02BB02]

Pharmacological properties

Pharmacodynamics

It has analgesic, antipyretic and mild anti-inflammatory effects, the mechanism of which is associated with inhibition of prostaglandin synthesis. It is a derivative of pyrazolone.

Pharmacokinetics

In intravenous administration: onset of action – after 5-10 minutes, maximum effect – after 5-30 minutes, duration of action – up to 2 hours. It is metabolized in the liver, a small concentration of unchanged sodium metamizole is found in the plasma, it is excreted by the kidneys. In therapeutic doses penetrates into the mother’s milk.

Indications

Severe acute or chronic pain syndrome in trauma and postoperative pain syndrome, colic, cancer and other conditions where other therapeutic measures are contraindicated. Fever that is resistant to other therapies.

Active ingredient

Sodium metamizole

Composition

Active ingredient:

metamizole sodium – 250 mg or 500 mg;

excipient:

water for injections – up to 1 ml.

How to take, the dosage

Parenteral administration is indicated only if oral administration is not possible.

We recommend warming to body temperature before administration.

Adults and adolescents 15 years and older: as a single dose, 1-2 ml 50% (500 mg/ml) sodium metamizole (intramuscular or intravenously) is recommended, the maximum daily dose may be up to 4 ml 50% injectable solution (no more than 2 g), divided into 2-3 doses. The maximum single dose can be 1 g (2 ml of 50% solution injected).

Children: Sodium metamizole is contraindicated under 3 months of age or if the body weight is less than 5 kg.

In children, sodium metamizole is indicated in a dose of 50-100 mg per 10 kg of body weight (0.1-0.2 ml of 50% solution).

A single dose can be prescribed up to 2-3 times a day.

Injection only intramuscularly for children aged 3-12 months (child weight 5-9 kg).

Intravenous infusion should be carried out slowly (infusion rate of no more than 1ml (500 mg of sodium metamizole per minute)) in the supine position, while monitoring blood pressure, pulse and respiratory rate to minimize the risk of reduced blood pressure.

At the first sign of anaphylactic/anaphylactoid reactions, discontinue the drug.

Because there is concern that the drop in blood pressure of non-allergic genesis is dose-dependent, amounts of sodium metamizole solution greater than 2 ml (1 g) should be administered with extreme caution.

A critical drop in blood pressure and shock may occur if the drug is administered too rapidly.

Elderly patients should use lower doses due to possible decreased excretion of sodium metamizole metabolites.

Patients in severe condition and with impaired creatinine clearance need to use lower doses due to a decreased excretion rate of sodium metabolites of metamizole.

In patients with impaired hepatic or renal function the excretion rate of the drug is slower; therefore repeated use of the drug should be avoided; no experience of long-term use is available.

Dose adjustment is not required for short-term therapy.

Length of treatment

When used as an analgesic, the duration is 1-5 days. When used as an antipyretic 1-3 days.

Interaction

Due to a high likelihood of pharmaceutical incompatibility, should not be mixed with other drugs in the same syringe. It enhances the effects of ethanol; concomitant use with chlorpromazine or other phenothiazine derivatives may lead to severe hyperthermia.

X-ray contrast agents, colloidal blood substitutes and penicillin should not be used during treatment with sodium metamizole. If cyclosporine is concomitantly administered, the blood concentration of the latter decreases.

Sodium metamizole, displacing oral hypoglycemic drugs, indirect anticoagulants, glucocorticosteroids and indomethacin from binding to protein, increases their activity. Phenylbutazone, barbiturates and other hepatoinducers during concomitant use decrease the effectiveness of sodium metamizole.

Concomitant administration with other non-narcotic analgesics, tricyclic antidepressants, contraceptive hormones and allopurinol may lead to increased toxicity, Sedatives and tranquilizers increase the analgesic effect of sodium metamizole.

Thiamazole and sarcolysin increase the risk of leukopenia. The effect is enhanced by codeine, histamine H2-blockers and propranololol (slows inactivation). Myelotoxic drugs increase the manifestation of hematotoxicity of sodium metamizole.

Special Instructions

When treating children under 5 years of age and patients receiving cytostatic agents, analgin should be administered only under medical supervision. In patients with atopic bronchial asthma and pollinosis there is an increased risk of hypersensitivity reactions.

With prolonged (more than a week) use, monitoring of peripheral blood picture and functional state of the liver is necessary.

During analginum administration agranulocytosis may develop, therefore immediate discontinuation of the drug is necessary if unmotivated fever, chills, sore throat, difficulty in swallowing, stomatitis, and if vaginitis or proctitis occur. Intolerance is very rare, but the risk of shock after IV administration is relatively higher than after oral administration.It is not acceptable to use for acute abdominal pain (until the cause is determined). A long needle should be used for intravenous administration.

Contraindications

Hypersensitivity to pyrazolone derivatives (phenylbutazone, tribuzone), susceptibility to bronchospasm.

Severe liver and/or renal dysfunction, glucose-6-phosphate dehydrogenase deficiency, blood diseases, hematopoiesis suppression (agranulopitosis, cytostatic or infectious neutropenia) as well as – anemia and leukopenia. Bronch obstruction, rhinitis, urticaria provoked by taking acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (including anamnesis), active liver disease, condition after coronary artery bypass surgery; confirmed hyperkalemia, erosive and ulcerative changes of the mucosa of the stomach and 12 duodenum, active gastrointestinal bleeding, inflammatory bowel disease.

Use during pregnancy and lactation.

Do not use during pregnancy (especially during the first 3 months and the last 6 weeks) and during lactation.

With caution

Ischemic heart disease, chronic heart failure, cerebrovascular diseases, dyslipidemia/hyperlipidemia, diabetes, peripheral arterial disease, smoking, creatinine clearance less than 60 ml/min. anamnestic data about the development of gastrointestinal ulcers, the presence of H. pylori, advanced age, long-term use of nonsteroidal anti-inflammatory drugs, severe somatic diseases, concomitant use of oral glucocorticosteroids (including prednisolone), anticoagulants (including warfarin), antiplatelet agents (including acetylsalicylic acid, clopidogrel), selective serotonin reuptake inhibitors (including citalopram, fluoroamide), and other drugs. citalopram, fluoxetine, paroxetine, sertraline).

Particular caution is required when prescribing to patients with systolic blood pressure below 100 mm Hg. or with circulatory instability (e.g., myocardial infarction, multiple trauma, onset of shock), with anamnestic evidence of renal disease (pyelonephritis, glomerulonephritis) and with a long history of alcohol abuse.

Side effects

The drug is well tolerated in therapeutic doses.

When using the drug in individual patients there may be adverse reactions: allergic reactions (skin rash, Quincke’s edema, rarely anaphylactic shock, Stevens-Johnson and Lyell syndrome, bronchospasm); with prolonged use agranulocytosis, leukopenia, thrombocytopenia, arterial hypotension, interstinal nephritis may occur. Renal dysfunction, oliguria, anuria, proteinuria, staining of urine in red.

If prone to bronchospasm, provoking an attack is possible. In case of intravenous injection infiltrates at the injection site are possible.

Overdose

Symptoms: nausea, vomiting, gastralgia, oliguria, hypothermia, decreased blood pressure, tachycardia, shortness of breath, tinnitus, drowsiness, delirium, loss of consciousness, acute agranulocytosis, hemorrhagic syndrome, acute renal and/or liver failure, seizures, respiratory muscle paralysis.

Treatment: induction of vomiting, percutaneous gastric lavage, saline laxatives, activated charcoal; performing forced diuresis, hemodialysis, in case of convulsive syndrome – intravenous infusion of diazepam and quick acting barbiturates.

Similarities

Analgin Ultra, Baralgin M, Analgin, Analgin Renewal